| NPI | 1174778286 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA06925) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.003344) |
| Enumeration Date | 2008-11-18 |
| Last Update Date | 2021-12-06 |